MEDICARE: BRAINTREE DENTISTRY AND BRACES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	1223P0221X	Pediatric Dentistry
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry
3	122300000X	Dentist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437784378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRAINTREE DENTISTRY AND BRACES PC

Provider Business Mailing Address
First Line	:	5 MOUNT ROYAL AVE STE 300
Second Line	:
City	:	MARLBOROUGH
State	:	MA
Zip	:	01752-1900
Country	:	US
Telephone Number	:	508-872-3072
Fax Number	:

Provider Business Practice Location Address
First Line	:	292 GROVE ST
Second Line	:
City	:	BRAINTREE
State	:	MA
Zip	:	02184-7209
Country	:	US
Telephone Number	:	781-353-6030
Fax Number	:

Authorized Official
Title or Position	:	CHIEF REVENUE OFFICER
Name	:	TODD PACHELLO
Credential	:
Telephone Number	:	720-475-6482

Provider Enumeration Date	:	03/11/2020
Last Update Date	:	03/23/2026

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